New Dreamwear = high AHI when AWAKE!

[Recipefordisaster]

This is very strange.... AirSense10 at 4-20, usually hover at 6-7, with no ramp, and have been using my Amara View. That has its own issues which are difficulty keeping seal and very chapped area under my nose. I've been using it 6 months anyway.

I got the Dreamwear which seems to fit great and is very comfortable, and excitedly went to bed with it. There were no leaks that I could find and I'm very sensitive to the feeling or sound of air escaping anywhere, so I'm pretty confident. The only issue with mask fit is that the headgear strap tends to ride up and make the mask loose, but I never got to worry about that much....

As I tried to go to sleep, I noticed much more noise both from the mask and the machine, then I did have trouble keeping it sealed as I tossed and turned but it felt very different. This only got worse and my chest started feeling uncomfortable. I looked at the machine and it was up to 16! I've never been that high. I checked everything, humidifier sealed, tubing secure, etc. and found no problems so I restarted the machine. It went from 4.. To 6... And then kept climbing for no apparent reason. I never fell asleep with it (husband agrees and my FitBit does too) and kept tweaking things (setting for nasal vs. FFM on machine) and restarting the machine. Nope, every time, the pressure just kept going up. This didn't happen with the Wisp I tried recently (hurt my nasal bridge and went back) and nothing has changed. When I looked at the sleep report I found AHI 4-5 TIMES my usual when sleeping (same AHI even during periods where I only had the machine running for 20 minutes to try to fix things) ... But I was awake and definitely breathing continuously!! Leak reported was zero and my DME said the machine wasn't reporting any issues so it must be leaking somewhere to cause this issue. ??? I asked the doctor to lower the upper pressure limit but played phone tag where he advised me to have the machine checked instead I know I can do this but the DME is strongly advising me I'd better not for legal reasons.

The first night of struggle I actually removed the mask and slept without it, it was after 1am and I felt awful. Since I knew the new mask fit well and was pretty quiet, I was confident I would use it all night so didn't have my old mask within reach for switching.

Last night I switched to my Amara after 10:30pm and a repeat of the issue when trying the Dreamwear, and things were fine. Usual AHI and pressure reported. No escalating out of control!

What could cause this odd overdetection and then higher and higher pressure? I don't think I've ever hit 9 before this.

[hope4sleep]

I forgot to change the mask settings on my machine once and had major issues. I had full face mask selected using an Airfit P10.....it hammered my nose all night!!!

[OpalRose]

Recipefordisaster,
What software are you using to determine how high the pressure is going? I suggest you download Sleepyhead software (link at top of page) to track your data.

If your mask is causing you to get a high leak rate, then your AHI reading will be suspect.

[Recipefordisaster]

I am using the machine's display for now, haven't had a chance to put the SD card in the computer and I use a tablet since I'm not with that computer. I do have Sleepyhead but with the machine's reported leak at zero, corroborated by my feeling that there are no leaks, I'm pretty confident. I should add that whenever I've had real leaks when trying a mask, or a bad night with the Amara, I never end up with high pressure and definitely never a falsely high AHI. Low, maybe, but not high.

I did change the mask style on the machine and nothing seemed different no matter which I chose. I started with it on nasal with the Dreamwear, though.

I do have an appointment with the DME on Tuesday but I know my luck: everything will perform smoothly and I'll look like a wacko.

[ratherberiding]

I suggest you unplug your machine for a while to let it reset then try again.
Good Luck

[Crimson Nape]

Ultimately, it could boil down to the common "anatomy incompatibility issue" with the mask. That's why there are so many different masks on the market. . . that and keeping us hose-heads buying different ones in search of the "Golden Mask".

[Recipefordisaster]

I did unplug the machine between nights of use. No difference. Also, without resetting between masks, I had no unusual trouble with the Amara last night. It did not increase pressure or report a false AHI.

The thing is, I need something that avoids the bridge of my nose and I can't use pillows... This mask fits beautifully, comfortably and securely, so I really want to make it work. I also love the connection being on top of my head. It seems to me that it's a combination of the mask and machine that is the issue, not simply the mask. I haven't found anything more comfortable than this one. I could use more ideas as to what to try.... Airfit FFM and nasal mask, Wisp, and Amara View are what I've tried. I want a nasal mask but it is tough to avoid the nasal bridge. The Wisp hurt a lot even with it very very loose, and it seemed so cushiony.... But after 4 hours I'd wake with bony pain.

[Sleeprider]

If the pressure seems to go higher than normal, why not set a lower maximum pressure? If you machine never went higher than 14, you can set it there and deal with the mask issues without the pressure running away. Easy fix, more comfortable, and lots better than foregoing therapy.

[Recipefordisaster]

As I said, the DME is a bit threatening about my changing the pressure on my own and I think they'll see it. I also mentioned that my doctor wanted me to have the equipment checked rather than reducing the pressure, but I will try again on Monday. I am back to the Amara as opposed to not using the machine, it was just that first night I didn't switch back so I used nothing for a few hours.

However, even if the max pressure was 10, something is still wrong with detection and I probably don't need it higher than 8 most of the time. I wouldn't want too small a window as I feel that defeats the automatic nature of the machine.

[OpalRose]

As I said, the DME is a bit threatening about my changing the pressure on my own and I think they'll see it. I also mentioned that my doctor wanted me to have the equipment checked rather than reducing the pressure, but I will try again on Monday. I am back to the Amara as opposed to not using the machine, it was just that first night I didn't switch back so I used nothing for a few hours.

However, even if the max pressure was 10, something is still wrong with detection and I probably don't need it higher than 8 most of the time. I wouldn't want too small a window as I feel that defeats the automatic nature of the machine.

Do you know your 90% pressure? It should show on display. Your max pressure shouldn't be much above that.

Oh, and you do know that their are no Cpap police, right? Even though you DME is trying to be one.

If your worried about compliance, all insurance looks at is the hours of use, not what pressure you are using.